On the other hand, if you ever get the urge to open bottles with your mouth, using someone else’s teeth is a much better choice.

Those wanting something a little more upscale could go for some toothyfashions:

Or be both extravagant and practical by giving the full line of Margaret Josefin toothpastes from Japan, one flavor for every tooth, including such favorites as Tropical Pine, Curry, Pumpkin Pudding and Monkey Banana!

But if you’re going to give someone a cavity or bad breath, you’re safest sticking with this kind:

Are today’s toothpaste ads really so different? Each brand still insists that it’s better than the rest – because it has fluoride or baking soda or peroxide or nanosilver or Xylitol or triclosan or whatever.

But truth be told, toothpaste doesn’t do all that much to keep your teeth and gums clean and healthy. In fact, one study, published in the Journal of Periodontology, actually found brushing without paste to be more effective than brushing with it.

Researchers concluded that brushing without toothpaste was more effective in removing plaque from the front surface of teeth. The mechanical action of brushing (moving the brush up and down or sideways) may have been the main factor in determining effectiveness of plaque removal, they said.

This is why cleaning technique matters. Brushing (and flossing) breaks up the biofilm (“plaque”) that forms on your teeth between cleanings – and that’s the key, not necessarily what you break it up with. Our ancient ancestors used things like chew sticks and twigs. Even today, at least one entrepreneur is marketing Miswak twigs as an eco-friendly alternative to regular brushing. In India, twigs of neem – which has antimicrobial properties – are still commonly chewed to clean the teeth.

What toothpaste does offer is grit – silica, calcium carbonate, chalk, alumina or other abrasive to help break up the biofilm. Abrasives can also help remove stains from the teeth, but sometimes at a cost to their enamel, as results of a recent study in the Journal of Clinical Dentistry suggest.

Anything with an RDA, (Relative Dentin Abrasion) score of about 100 is generally considered highly abrasive. Anything above 150 is considered potentially damaging to enamel.

Here’s how some of the popular whitening toothpastes stacked up:

Crest White Vivid scored above 200.

Rembrandt Intense Stains was only mildly abrasive with an RDA of 90.

Ultrabrite Advanced Whitening from Colgate had an RDA of 260, one of the most abrasive.

Of course, toothpastes contain more than abrasives. Most mass market toothpastes contain fluoride, foaming agents, detergents, humectants, thickeners, flavoring and sweeteners. Not all of these are benign. For instance, sodium lauryl sulfate (SLS) – a common foaming agent also used in shampoo, dish soap and other products – has been shown to damage the soft tissues of the mouth.

Some also contain remineralizing agents, although there’s little evidence that they strengthen enamel as the ads say they do. Others tout antimicrobials such as nanosilver and triclosan. We still don’t know much about nanosilver’s biological effects, though early animal studies suggest cause for concern. Triclosan, on the other hand, is a suspected endocrine disruptor and probable carcinogen. The chemical reaction that occurs when it’s combined with chlorinated water (98% of the public water supply) produces chloroform.

Fortunately, it’s easier than ever to find gentle, natural alternatives – pastes made without detrimental ingredients, with essential oils and herbal extracts that support oral and dental health. This article from Natural Solutions contains some good tips on choosing one.

There’s an interesting double standard in medicine – dental and otherwise. Conventional practitioners can and do promote all sorts of treatments that haven’t been empirically proven or that work in ways we don’t yet understand. At the same time, many insist that “alternative medicine” isn’t valid because many of its treatments aren’t yet proven or understood. Yet when proof is provided, the tendency is to ignore it, discount it or move the goal-posts, holding traditional and natural healing practices to a higher standard than they hold their own. If we say there’s only one kind of medicine – that which works – then shouldn’t all of its premises and practices be held to the same standard?

Science is not a body of knowledge but a process – a way of understanding the world through what can be observed, measured and tested. The tools of science are also always evolving, letting us see more – or more precisely – than before. What can’t be proven in one era may be proved in another as knowledge and technology evolve. What seems like magic to one generation may come to seem common sense to later ones.

But what about fluoride in toothpaste? A new study published in Langmuir, the journal of the American Chemical Society, raises some questions.

In a study that the authors describe as lending credence to the idiom, “by the skin of your teeth,” scientists are reporting that the protective shield fluoride forms on teeth is up to 100 times thinner than previously believed. It raises questions about how this renowned cavity-fighter really works and could lead to better ways of protecting teeth from decay, the scientists suggest….

Scientists long have known that fluoride makes enamel — the hard white substance covering the surface of teeth — more resistant to decay. Some thought that fluoride simply changed the main mineral in enamel, hydroxyapatite, into a more-decay resistant material called fluorapatite.

The new research found that the fluorapatite layer formed in this way is only 6 nanometers thick. It would take almost 10,000 such layers to span the width of a human hair. That’s at least 10 times thinner than previous studies indicated. The scientists question whether a layer so thin, which is quickly worn away by ordinary chewing, really can shield teeth from decay, or whether fluoride has some other unrecognized effect on tooth enamel.

We might also ask, is it really the fluoride at all? For toothpaste really isn’t the biggest factor when it comes to good oral hygiene – which isn’t to say that it has no role. Its main role is to act as a mild abrasive to help break up the biofilm (plaque) that forms on your teeth between cleanings. (Toothpastes that contain elements such as antimicrobials play a dual role in supporting oral health, but their main function is still as an abrasive.) More important are things like brushing regularly and well, flossing and/or using a proxy brush – both of which have a much bigger impact on oral health than brushing alone.

As a dentist, I do not use fluoride, nor do I recommend it to my patients. For hygiene products I do recommend, click here.

We’re often overwhelmed by choice. Just think of your local supermarket and its aisles brimming with so many dozens of kinds of breakfast cereal, soup, crackers, cookies and other products. Most of the time when we do our shopping, we don’t pay attention to the plentitude. When we do become aware of it, it can be truly mind-boggling.

Of course, the matter of too much choice isn’t restricted to groceries but a whole array of consumer goods, from cars to computers, TVs to toothpaste. Anymore, it seems any innovation is glommed onto as quickly as possible to create new products that can stand out amidst the glut of old, familiar ones. And we all know newer is better, right?

Not necessarily. “New” isn’t always “improved.” And sometimes we rush to embrace new things without asking whether they’re really an improvement or what their potential drawbacks might be.

One new technology in dental care products that we may want to ask these questions about is the use of nanosilver in toothpastes.

The first question, though, is why nanosilver – very tiny bits of silver used to coat an item or be suspended in it? The answer is simple: it’s been shown to have antibacterial qualities. So considering that pathogenic microbes – “bad” oral bacteria – play a role in tooth decay and gum disease, it would seem to make good sense to use nanosilver to kill those “bad germs.”

Nanoparticles behave quite differently from their regular-sized counterparts. Their comparatively large surface area increases their biological activity. Moreover, the particles themselves are much smaller than cells. Nanoparticles can be absorbed through the skin, eyes or nose. They can even cross the blood-brain barrier.

For example, although titanium dioxide is biologically inert, nano-titanium dioxide particles have been shown to damage DNA. Nano-titanium dioxide is estimated to be in over 10,000 consumer products today, including cosmetics, medicines and toothpaste.

Another major nanotech invention, carbon nanotubes have amazing strength. Unfortunately, they can also cause more lung damage than asbestos.

What biological effects might nanosilver have? We don’t really know yet, though some animal studies – such as this one – have shown potential for harm. Much research remains to be done – not just on nanosilver but the full array of nanomaterials.

And what do dentists think about all this? According to a Wealthy Dentist survey, only 6% would recommend it, while 26% would recommend against it and 69% say they don’t know enough about it to say. But caution does seem to be called for. As one Texas dentist put it, “There is not enough scientific evidence that it is more efficacious than other more proven products, and there’s some disturbing evidence that it might do harm.”

What’s more, toothpaste itself plays a minor role in fighting tooth decay, serving mainly as an abrasive to help break up the biofilm (plaque) that forms on your teeth between cleanings. More important is how you brush, as well as whether or not you floss.